06D0644454 CLIA NUMBER - VALLEY WIDE HEALTH SYSTEMS

Laboratory Demographics

CLIA Number: 06D0644454

Facility Name: VALLEY WIDE HEALTH SYSTEMS

Facility Address:
128 MARKET STREET
ALAMOSA, CO
ZIP 81101
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Facility Phone Number: 719 589-3658

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1154377356

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	06D0644454
LAB Type	Federally Qualified Health Center
Facility Name	VALLEY WIDE HEALTH SYSTEMS
Street	128 MARKET STREET
City	ALAMOSA
State	CO
ZIP	81101
Phone	719 589-3658
CertificateType	3
CertificateEffectiveDate	6/25/2023
CertificateExpirationDate	6/24/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024